title: Epidemiological and clinical correlates of malaria-helminth co-infections in Southern Ethiopia.
abstract: BACKGROUND
  In many areas of the world, including Ethiopia, malaria and helminths are co-endemic, therefore, co-infections are common. However, little is known how concurrent infections affect the epidemiology and/or pathogenesis of each other. Therefore, this study was conducted to assess the effects of intestinal helminth infections on the epidemiology and clinical patterns of malaria in southern Ethiopia where both infections are prevalent.
  
  
  METHODS
  A cross-sectional study was conducted in 2006 at Wondo Genet Health Center and Bussa Clinic, southern Ethiopia. Consecutive blood film positive malaria patients (N=230) and malaria negative asymptomatic individuals (N=233) were recruited. Malaria parasite detection and quantification was diagnosed using Giemsa-stained thick and thin blood films, respectively. Helminths were detected using direct microscopy and formol-ether concentration techniques. Coarse quantification of helminths ova was made using Kato Katz method.
  
  
  RESULTS
  The over all magnitude of intestinal parasitic infection was high irrespective of malaria infection (67% among malaria positive patients versus 53.1% among malaria non-infected asymptomatic individuals). Trichuris trichiura infection was associated with increased malaria prevalence while increased worm burden of helminths as expressed by egg intensity was associated with increased malaria parasitaemia which could be a potential factor for development of severe malarial infection with the course of the disease. Majority (77%) of the subjects had multiple helminths infection. T. trichiura, Ascaris lumbricoides, Schistosoma mansoni, and hookworm infestation accounted for 64.5, 57.7 %, 28.4%, and 12.2% of the infections, respectively.
  
  
  CONCLUSIONS
  Populations in malaria-endemic areas of southern Ethiopia are multi-parasitized with up to four helminths. Mass deworming may be a simple practical approach in endemic areas in reducing the risk of severe malarial attack particularly for those at high risk of both infections.
authors.affiliation: School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia. beyemoges@gmail.com
authors.forename: Andargachew
authors.initials: A
authors.lastname: Mulu
authors.forename: Mengistu
authors.initials: M
authors.lastname: Legesse
authors.forename: Berhanu
authors.initials: B
authors.lastname: Erko
authors.forename: Yeshambel
authors.initials: Y
authors.lastname: Belyhun
authors.forename: Demise
authors.initials: D
authors.lastname: Nugussie
authors.forename: Techalew
authors.initials: T
authors.lastname: Shimelis
authors.forename: Afework
authors.initials: A
authors.lastname: Kassu
authors.forename: Daniel
authors.initials: D
authors.lastname: Elias
authors.forename: Beyene
authors.initials: B
authors.lastname: Moges
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006373:Helminthiasis / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D006376:Helminths / Q000145:classification; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D007411:Intestinal Diseases, Parasitic; D008288:Malaria / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult